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Home My WebLink About10-1125 �/ � CITY OF DIAMOND BAR �a h `��9�3��"� ' �J ' � ^---"��"— DEPARTMENT OF COMMUNITY&DEVELOPMENT SERVICES 1� � W 21825 Copley Drive,Diamond Bar,CA 91765 � � (909)839-7020 Fax(909)861-3117 Building Inspection Hotline(909)839-7027 PRESS '��' BUILDING PERMIT APPLICATION FIRMLY � JOBSITE � ^CRy� ,, Q �'G:�� F�,(L��/ �-�� i�D, �fZ� DATE CATION NUMBE�D" I�� lC ¢ ADDRESS Y�`: � ISSUE //� ��/� TYPE OCC APN LOT TRACT DATE Q� 'V CONST.�_ GROUP p OWNER �Zi G ��_i��'n i'� ADDRESS SGi Pr'� � ZONING SETBACKS � FRONT pyy ❑ z CITY ZIP TEL. ❑ p APPLICANT TEL. S DE/SIDE STREET RW ❑ z Q CONTRACTO O S SIDE p o ADDRESS I r PROPOSEDUS -�� LG�.G� GJC6''f-�/1r9 �f2Ci't�Nc� CITY Ll�G�,vri� ZIP� TEL.RD9•�'ISTL"� P o ARCH/ENG/ �—��L7--�� "�"`� ��—��f-� z DESIGNER w NO.DWEL. NO. NO. a ADDRESS � CITY ZIP TEL. UNITS STORIES BEDROOMS � cn DESCRIPTION SQ.FT. FACTOR PSF ADJ.AREANALUATION Q OWNER-BUILDER DECLAfiATION SFR/ADD/REM O I HEREBV AFFIRM UNDEH PENALTV OF PERIURV THAT I AM ExEMPT FROM THE CANiRACTORS LI- G8f8g0IC0fp0ll W CENSEUWFORTHEFOLLOWINGHEASON(SEC.7037.SBUSINESSANDPROFESSIONSCADE:ANVCITYOR (n U COUN7YWH�CHREOUIRESAPERMITTOCONSTRUCT,ALTER,IMPROVE,DEMOLISH,ORREPAIRANVSTRUC� � w TURE,7RIOR TO ITS ISSUANCE,AL50 RE�UIRES THE APPLICANT FOR SUCH PERMIT TO FILE A SIGNED w Patio/Deck S7A7EMENT THAT HE OR SHE IS LICENSED PURSUANT TO THE PROVISIONS OF THE CONTRACTORS LI� � CENSE LAW(CHAP7ER e(COMMENCING WITH SEC710N 7000)OF DIVISION 3 OF 7HE BUSINESS AND PRO� � POOUSP2 Q FESSIONS CODE)OR THAT HE OR SHE IS EXEMPT THEREFROM AND THE BASIS FOR THE ALLEGED EXEMP- � V TION.ANV VIOLATION OF SECTION 7031.5 BV ANV APPLICANT FOR A PERMIT SU&IECTS THE APPLICANT TO Z Re-Roof A CIVIL PENALTY OF NOT MORE TMAN FNE HUNDRED DOLLARS(5500).): Z ❑I,ASOWNEROFTHEPROPERTY,ORMYEMPIOVEESWITHWAGESASTHEIRSOLECAMPENSATION, � COrt1rtI0fClal WILL DO THE WORK,AND THE STRUCTURE IS NOT INTENDED OR OFFERED FOR SALE(SEC.70��,BUSI- J � NESS ANO PROFESSIONS CADE:THE CON7RACTOqS LICENSE LAW DOES NOT APPLV 70 AN OWNER OF � PROPER7Y NM1iO BUILOS OR IMPROVES THEREON,AND WHO DOES SUCH WORK HIMSELF OR HERSELF OR � THROUGH HIS OR HER OWN EMPLOYEES,PROVIDED 7HAT SUCH IMPROVEMENTS ARE NO71N7ENDED OR m Q OFFEREDFORSPLE.IF,HOWEVER,7HEBUILDINGORIMPROVEMENTISSOLDWITHINONEYEAROFCOMP�E� Z TION,THE OWNER-BUILDER WILL HAVE THE BURDEN OF PROVING THAT HE OR SHE DID NOT BUILD OR � IMPROVE FOR THE PURPOSE OF SALE). w ❑I,ASONMEROFTHEPROPER7Y,AME%CLUSIVELYCONTRACTINGWITHLICENSEDCONTRACTORS � 70 CONS7RUCT THE PR0.IECT(SEC.701/,BUSINESS AND PROFESSIONS CODE:THE CONTMCTORS LI- V81U8SIOn ADJ.AREA W CENSE LAW OOES NOT APPLV TO AN OMMER OF A PROPERTY WHO BUILDS OR IMPROVES THEREON,AND � NM1iOCONTRACTSPORSUCHPROJECTSWITHACANTRACTOR(S)LICENSEDPURSUAN770THECONTRAP QUANTITY DESCRIPTION FEE Y TORS LICENSE LAW.�. �� ❑I AM EXEM7T UNDER SEC. B.6 P.C.FOR THIS REASON Q U u� ¢ DATE OWNER � Z w � LICENSED CONTRACTORS DECLARATION w � I HEREBY AFFIRM UNDER PENALTY OF PERJURY THAT I AM LICENSED UNDER PROVISIONS OF CHAPTER � d Y(COMMENCINGWITHSECTION7000)OFDIVISION30FTHEBUSINESSANDPROFESSIONSCODE,AND Z X MY LICENSE IS IN FULL FORCE AND EFFECT. m LLI / // � UCENSE CLASS C'"ZO �'��o �•�L��.No. 3 Z�99 O � . � V DATE ��" �I�- l�� coNrancroa ��C�2;j ;� .S["1r^�_C a � WORKERS'COMPENSATION DECLARATION f Q � • , 9 /, �p,� v w ��- � I HEREBV AfFIRM UNDER PENALTV OF PERJURY ONE OFTHE FOLLOWING DECURATIONS: Z �r r Q V � I HAVE AND WILL MAINTAIN A CERTIFICATE OF CANSENT TO SELF-INSURE FOR WORKERS' _ �p � � CAMPENSA710N,AS PROVIDED BY SEC710N 370o OF THE LABOR CODE,FOR 7HE PERFORMANCE �U Y1+'� V� OF THE WORK FOR WHICH THIS PERMIT IS ISSUED. � � w _I HAVE AND WILL MAINTAIN WORKERS'CAMPENSATION INSURANCE,AS REOUIRED BV SECTION Q 3700 OF THE LABOR CODE,FOR THE PERFORMANCE OF THE WORK FOR WHICH THIS PERMIT IS ISSUED.MV WORyKER�S�'CAMPENSATION INSURANCE CARfiIER AND POLICV NUMBER ARE: CONSTRUCTION j CARRIER s�-'""� �N.S J/'aa'�� PLAN REVIEW Z POLICVNUMBER t..,�r►5`rrQ..s z �ydz ELECTRIC a 0 (IHISSECTIONNE�NOTBE07lAPLEfEDOFT}�PER�MISFORONEFdN�DREDDOLI.WS�f/00)ORLESS) PLUMBING W Z I CERTIFV THAT IN THE PERFORMANCE OF 7HE WORK FOR WHICH THIS PERMIT IS ISSUED,I A L} SHALL NOT EMPLOY ANY PERSON IN ANV MANNER SO AS TO BECOME SUBJECT TO THE � WORKERS'COMPENSATION LAWS OF CALIFORNIA,AND AGREE THAT IF I SHOULD BECOME INSPECTION FEE = SU&IECTTO7HEWORKEFiS'COMPENSATIONPROVISIONSOFSECTION37o00FTHELABOR /�� CADE.I SHALL FORTHWITN COMPLY WITH THOSE PR ISIONS. ISSU CE SiVI l � DATE: � ��O APPLICAN SMIP wWARNING:FAILURE TO SECURE WORKE(i5'COMPENS�ATION COVERAGE IS UNUWFUL,AND SHALL BE ENERGY P/C � SU&IEC7ANEMPLOVERTOCRIMINALPENAL7IESANDCIVILFINESUPTOONEHUNDREDTHOUSAND ENERGYPERMIT DOLURS(f100,000).IN ADDITION TO THE COST OF COMPENSATION,DAMAGES AS PROVIDED FOR IN ,/� � SECTION 37oB OF THE LABOR CODE,INTERES7,AND ATTORNEY'S FEES. TENT N , lt�V a CONSTRUCTION LENDING AGENCY PRE-ALT FEE: O � I HEREBV AFFIRM UNDER PENALTV OF PERJURY THAT THERE IS ACONSTRUCTION LENDING AGENCV FOR THE PERFOflA1ANCE OF THE WORK FOR WHICH THIS PERMIT IS ISSUED(SEC.3087,CIV.C.). Z W � LENDER'S NAME F- LENDER'SADDRESS � 1 CERTIFV TFIAT I HAVE READ THIS APPLICATION AND STATE THAT THE ABOVE INFORMATION IS CARRECT. TOTAL F E ES � � W I AGREE TO COMPIY WITH ALL CITV AND COUNTY ORDINANCES AND STATE UWS flEUTING TO BUILDING � CANSTRUCTION,AND HEREBV AUTHORRE REPHESENTATIVES OF THIS COUNTV TO ENTEH UPON THE � ABOVE-MENTIONED PROPEFTV FOR INSPECTION PURPOSES. Z '�/ / , � COMMENTS ' � i�G,v� p�I�cS<iY�J�. J � m PERMITTEE NAME(PRINT) � � / �/� � SIGNA7URE MI77EE DATE I = RECPT.NQ - PAID BY � VALIDATION ~ WHITE—Department Copy,YELLOW--Financa Copy,PINK—Assessor Copy,GOLDENROD—File Copy,GREEN—Applicant's Copy I , �, �0'9"V O� ��,�ii01�� A� � , Ob�S��'�O�I �I��R� oa�p�c�400a Qa4� o��p�c�4oa oa�p��4aoa .o�a�� oa�p��u aa ��: SET BACK ' ( FLOOR JOIST FTGS/FORMS/STEEL � FHA REQMTS ELECTRIC GROUND � UNDER FLOOR DUCT . GROUND PLUMBING UNDER FLOOR CONDUIT SLAB GRADE FIREPLACE FOUNDATI�N TEMP POWER FIREPLACE BOND BEAM WATER SERVICE MID H'T. BOND BEAM ROOF SHEATHING , 8 FT. BOND 6EAM FRAMINGNENTILATION FINAL BOND BEAM ROOF COVER PRE-GRADiNG ROUGH HEATING BENCHING ROUGH ELECTRIC ROUGH GRADING ROUGH PLUMBING FINISH GRADING SHOWER/TU8 TEST POOL ELECTRIC _ EXT. LATH/SIDING POOL FENCING WALL INSULATION POOL FINAL CEILING INSULATION �FF SITE IMPS. DRYWALL NAILING DEDICATIONS SEWER FINAL ENG. SEPTIC TANK LANDSCAPE/IRRIG. SEEP PIT/�.L. ON SITE IMPS. _ ___ GAS AIR TEST FINAL ZONING FINAL CONST. FIRE DEPT. FINAL FINAL HEATING HEALTH DEPT. FINAL - -- - ------- ---- ----------.-------------------- FINAL ELECTRIC DEV. FEES PAID FINAL PLUMBING ENERGY C�1�Of�o c -- —--- COMMERlTS SEPTIC TANK SIZE SEEP PIT/U SIZE a � � --- --- -------- �